abortion

In Splinter the Silence, Val McDermid explores the issue of internet trolling/hate mail/harassment/villification/abuse of women who put their heads above the parapet to speak about discrimination and injustice. In this fictional case, the public figures are apparently hounded to the point of suicide, although the reader knows from the outset that they are actually being murdered, each killing disguised to mimic the suicides of famous feminists. The murderer has his own reasons for objecting to women who step outside their domestic role and tell men what’s right or wrong.

Well, sadly, I know people in real life who would still tether women to the kitchen sink if they could. I have myself come in for criticism for being a woman and daring to voice and defend an opinion; for having ideas above my subservient station. Fortunately, positive responses have far, far outweighed the negative, so it hasn’t been that difficult to maintain perspective, but then, I’m not an A-list celebrity, so such pernicious or malicious activities don’t hit the headlines, the number of critics doesn’t reach stratospheric levels. Nevertheless, I can vouch for the discomfort of being on the receiving end of such unjust vitriol. It’s not as far fetched as you might imagine.

This week I’ve been thinking a lot about the matter of standing up and being accountable, and about all the cases coming to public attention right now that lend themselves to strong column inches. I’ll itemise a few, but please note, I have no privileged access to information on any of them, so the facts I include are as subject to distortion and prejudice as any other media-generated stories.

OK, serious time, folks. And in every case multiply the questions many times over.

Ten days after legally completing his transition from female to male, a transgender man, TT, underwent intrauterine insemination, resulting in a pregnancy. He has now taken his case to the High Court in an effort to be the first to have no ‘mother’ registered on the birth certificate. Hello? ‘Cake’ and ‘eat’ instantly spring to mind. Expensive legal and parliamentary resources are to be deployed to look into the ramifications of the current laws governing fertility treatment.
One British doctor is reported as saying, now that it is medically possible to transplant a womb into biological males, it would be illegal to deny them access to this opportunity to carry a child to birth. What do you think? Would it?
What about the rights of the unborn child?
One author of a letter to the Telegraph outlined the scenario and concluded, ‘The lunatics truly have taken over the asylum.‘ Do you agree? Or is this a case of establishing the deep-seated needs of people who have struggled all their lives with their dysphoria?

Then there’s the issue of rights and dignity and bodily integrity and mental welfare of female athletes with naturally high testosterone levels? Renewed calls have been made for such women to be given drugs to lower their levels before they compete, or for them to be channelled into other categories such as intersex competition.
What about the effect on these sportswomen of the abuse and accusations levelled at them?
Is it a fair playing field?
Other scientists have cast serious doubt on the integrity of the research behind this latest demand; how many people either know of this or have the scientific or mental wherewithal to judge the issue fairly?

Exactly four years ago, on their half-term break, Shamima Begum and two school friends fled this country, aged only 15, to join Isil and become jihadi brides. In those years, Begum has borne three children, two of whom died of illness and malnourishment. She has told the world she doesn’t regret her actions, that she was unfazed by the sight of severed heads, that’s she’s into retaliation, but wants to bring baby number three back to her home country.
We have no way of knowing just how much coercion lies behind her public pronouncements, but her responses to interviewers chill the blood. The government have refused to jeopardise more lives by sending anyone to rescue her, but at first the lawyers told us, she’s a British citizen, she cannot be rendered stateless, so legally speaking, there is no choice; we must have her back. Then a couple of days later we hear that no, the government are not obliged to repatriate her … and indeed the Home Secretary has revoked her British citizenship … she has dual Bangladeshi nationality … the baby has a Dutch father …
What consequences should this girl’s actions have?
Whose rights take precedence?
What kind of a future lies in front of her or her baby son?
Who should assume responsibility?Is it a measure of our own more civilised behaviour that we rise above the terrorists’ creed and show compassion now towards this girl?
What of all the other people who’ve dabbled in terrorism but who now want to return?And a zillion other questions.
No wonder opinion is divided.

Retired accountant, 80-year-old Geoff Whaley, diagnosed with MND two years ago, decided that an agonising and undignified death was not for him; he would go to Dignitas in Switzerland for a controlled end to his life. But his careful planning was threatened days before his proposed departure by the appearance of police at his door, interviewing his wife of 52 years under caution, in response to an anonymous tip-off. It was this unwelcome intrusion, coupled with the laws of this country opposing assisted suicide, not his impending suicide, that engendered fear and anguish in this man, provoking him to protest to the BBC and MPs:‘The law in this country robbed me of control over my death. It forced me to seek solace in Switzerland. Then it sought to punish those attempting to help me get there. The hypocrisy and cruelty of this is astounding.’Put aside for a moment your personal views on assisted dying, and ask, what could possibly have motivated someone to blow the whistle in this way at the Whaley’s eleventh hour? Genuine concern, self-righteousness, extreme religious views, a sense of public duty, malice? Or what?
Should other people’s private scruples be allowed to control the rights of families in such tragic circumstances?

Imagine being born in war-ravaged Yemen, stranded in a hospital in a country where social, political, economic and health care systems have all collapsed, where about half of the 28 million inhabitants are living on the brink of famine. Now add to that the babies being conjoined twins. Their picture appeared in the British press; the Yemeni doctors appealing for help from the UN to get them to Saudi Arabia.
What should our response be?
What is our responsibility in such cases?
What chance did they realistically have?
At least 6,800 civilians have been killed and 10,700 injured in the war, according to UN statistics. Did these two extremely vulnerable boys warrant such an exceptional rescue mission?
In the event they died in their homeland, but the questions remain.

I have opinions on all these issues. You don’t have to listen to me. You are perfectly entitled to disagree with me – fundamentally and even vociferously. But you ought not to shut me up! Especially not in a threatening or damaging way.

Among the stacks of files for possible novels-I-might-write-some-day is one labelled ABORTION – a hot potato and one with evolving ethical and legal and philosophical issues.

I’ve personally lived through major change as a clinician in this area of practice. When I was in my early twenties, deliberately terminating pregnancy was illegal, and we midwives saw at first hand the damage done by so-called backstreet procedures carried out by unskilled hands. Then in 1967 the law changed to allow abortions to be carried out by trained professionals in certain circumstances. And gradually, over the years, those strict criteria have been relaxed. Nowadays, social circumstances and personal preference can be used as reasons to proceed; the mother’s mental well-being is invoked. But somehow a novel on the subject has slipped farther and farther down my priority list.

It remains a much more controversial issue in the States. Girls/women procuring an abortion have been incarcerated in prison for murder/homicide; professionals have been killed by ardent pro-lifers; centers offering the procedure have been attacked. (Jodi Picoult lists some of the sobering statistics in an appendix to her book on the subject.)

So perhaps it’s better that an American author has picked up the gauntlet and run with it. And I’d have said, Jodi Picoult was a natural choice to do so. She’s one of the four authors closest to my own genre of writing, and I’ve read (and own) pretty much all her books.

In A Spark of Light – just published – she’s tackled many of the issues I planned to include. The scene is The Center – formerly The Centre for Women’s Reproductive Health – the last standing abortion clinic – in Mississipi. The building is a hideous orange scar on the cityscape, everything inside it is run down, shabby, used. It’s protected by a perimeter fence, a border patrolled by zealous vigilantes /activists demonstrating outside it and against it.

Into this centre of controversy strides a very angry man with a gun and a personal agenda. He cold-bloodedly shoots some of the women and a male doctor before taking others hostage. His murderous rampage is fuelled by rage, because it’s in this place that the life of his own potential grandchild was taken; all he can think of is exacting revenge on those who were responsible.

Police negotiator Hugh McElroy is drafted in, initially unaware that his own teenage daughter and his sister are inside The Center. The two men establish contact. When he discovers that Bex (his sister) has been shot and seriously wounded, and that his girl Wren is being held hostage, it all becomes horribly personal.

The story unravels backwards in hourly increments. Hmmmm.

Picoult explores profound questions. Just where does the right to life end and the right to choose take over? When does killing for a cause (war, unwanted pregnancy) become murder? How can black and white legislation deal with the multiplicity of greyness that is people’s lives and experiences and beliefs? So far, so appropriate.

But sad to say this book did little for me. Sorry, Jodi.
Stylistically it simply doesn’t work. It starts with the shooting and unravels back to the reason each person is in that building at that time. Had I cared about any of the characters I’d have been interested in their backstory; but they were either too unbelievable or two-dimensional. As it was, with each chapter giving snippets about each one, I struggled to hold their identities in my head.
I was more concerned with how far the shooter would go, but then, blow me, after all that effort to follow the threads, the ending falls very flat. Promising story lines are left in limbo.
The agenda glares through the narrative, both visible and contrived.
The cod psychology is both intrusive and pervasive.
Everyone philosophizes and juggles competing ideals and thoughts and wise reflections, makes profound statements, encapsulates deep existential ideas in succinct phrases – completely unbelievable … especially in a crisis like this!
So disappointing.

So why do I offer such a negative review? Because the experience reminds me of the burden on authors – myself included. My own next book has the potential to disappoint my readership. I’ve strayed outside my comfort zone with this story and just this week one of my critics has pointed out many flaws – even questioned the appropriateness of the genre! It’s on hold at the moment, but in the new year I’m going to have to forensically dissect it and try to up my game.

Oh, and I dare to criticise Picoult on two counts. I’ve given her plenty of positive publicity in the past. And she’s rich and famous and confident enough not to be derailed by my humble opinion!!

What a week I’ve had! OK, I may be confined to barracks post-surgery, strictly forbidden (by authoritative medical personnel no less) from all housework or exertion of any kind, having to keep my leg elevated day and night … but, bored? Not a bit! Frustrated? Nope. Secretly sorry for myself? Certainly not! I’m capitalising on the situation and achieving far more than I ever anticipated. And buzzing! Has to be good for the soul.

OK, I knew it was coming. Before surgery I accumulated the usual materials for sedentary occupations like knitting, reading, writing, DVDs, etc etc. What I hadn’t bargained on was a complete takeover bid!

It started as soon as I began to actually write the annual Christmas story/play I compose and direct for my grandchildren. As part of my research I began dipping in and out of my all-time favourite books … soon lost in memories and other lives, somewhere in my head my own quite distinctive characters from different strata of society and various times in history who form the core of the play.

Then it was time to start actually committing ideas to the computer.

I began tentatively, feeling my way gently, setting the scene, getting to know the principals, but suddenly one after another they assumed accents and speech patterns and habits of their own. And away we went! Enormous fun. All without the constraints of my other kind of writing (this story is for a very select and exclusive readership indeed; not a single literary critic or publisher’s delicate sensibilities to be factored in).

On the day of the play itself, the youngsters will bring their own personalities to the characters as they assume their roles, but afterwards, once it’s in book form, I want these people to live on the page. Their mannerisms, their language, their reactions, must convey so much. It’s proved both a welcome challenge and a runaway delight!

Then there’s the side effect of recuperation. Lots more thinking-time. Without all the usual time-consuming domestic responsibilities there’s more leisure to watch TV and read papers, and it’s astonishing how many programmes and articles impinge on my own fields of interest. Factual as well as fiction, they make me reflect, which has to be good for my mental state.

So, for example, there’s the news this week of a patient who’s been in a persistent vegetative state for 15 years, who has now had his vagus nerve stimulated to some effect, putting him into a minimally conscious state. Progress, you might think. Clever stuff. Could this be the start of new hope for many? But hey! Is it really better to be aware you can’t move or do anything spontaneously? Would I want such a thing for my husband/son/brother in his thirties? Does this influence my thinking on assisted dying?

Then there are the up-coming court cases. Victims of the contaminated blood scandal from the 1970s/80s have finally won a ruling allowing them to launch a High Court action. Imagine! Forty years of waiting! And they’re a long way from a resolution or compensation even now. Something in the region of two and a half thousand – 2,5000! – have already died. Whose fault is/was it? What are the pros and cons of a legal system that grinds so slowly? How could we deal more effectively with such a catastrophe in the future?

And what about the families devastated by the consequences of giving Sodium Vaproate to pregnant women. That too goes back decades and it’s left to the families to fight on for justice. My brain is throwing up questions and doubts right left and centre. Not necessarily for a book; just challenges about the morality of what’s done in the name of medicine.

Ahhh, back again comes that old chestnut, abortion. Irish girls have been coming to England and Scotland to have pregnancies terminated for decades. (I remember being troubled by the questions way back in 1960s when I was in clinical practice and saw it first hand.) This week it was announced that Ireland is to hold a referendum next year on whether to repeal its ban on abortion in almost all circumstances. Are the issues any different today? Could this have been resolved more appropriately? Should religion influence laws? Is a referendum the best way forward? And what about all the other forms of medical tourism …?

The BBC2 programme aired a couple of days ago, Being Transgender, was billed as dealing with ‘one of the hot topics of the moment’. Well, that was my thinking when I published Inside of Me last year. But even though I’d immersed myself in the topic of gender and identity for a couple of years, I was still fascinated by these personal experiences, still wondering about the issues, but be warned, the footage of reassignment surgery in this case is pretty shocking.

So all in all the days are flying by faster than I feared they would. My mind is in overdrive. And I’m hoping to be ahead of the game when I return to normal functioning … God willing.

All except one of my trusted readers/critics have now given me their feedback on my latest book, Listen. Exciting times. But before I sit down for a serious edit, I’m immersing myself in some exquisite writing, beautiful language from the pen of a master, that will be a incentive to me to raise my own game – I hope!

The author? Patrick Gale. The book? A Place Called Winter. A sad, tender, compelling tale of Harry Cane’s battle with his own demons, the taboos of his day, and the wild wastelands of a new country. It’s an intensely personal novel inspired by a true story from Gale’s own family history: one gay man reaching out with sympathy and deep feeling to another (his mother’s grandfather) across a century of social change.

Harry Cane is born into privilege, raised to ‘believe that what mattered was to be unmistakably a gentleman’. He rides horses; others muck out their stables. His soft hands remain idle while callouses build up on the palms of his social inferiors. But his childhood is emotionally impoverished, with his mother dead and his father absent, schooldays punctuated by all the trials upper class boys can inflict on those they see as weaker prettier mortals. Consequently his life is centred on his younger brother Jack. It’s Jack who drags his shy insecure brother into society after their father’s death and introduces him to Winifred Wells, his future wife. Theirs is a gentle undemanding relationship which reluctantly produces one daughter before it settles into platonic coexistence.

The time is the early 1900s; apartheid is unchallenged; class distinctions rule; abortion and homosexuality are unlawful, the latter punishable by hard labour and utter disgrace; ‘treatment’ for psychiatric illness and ‘deviance’ is draconian. When his brother-in-law discovers Harry’s guilty secret, Harry – now an exiled ‘unmentionable‘ – signs up for a new start in a new country, Canada, one of 511 passengers on a ship sailing to the unknown.

The vast impossible prairies are simply waiting to be tamed, and after serving his year-and-a-day apprenticeship to a Danish farmer, Harry commits himself to converting 160 acres of wild wasteland into a self-sufficient thriving homestead within three years. Setting out with simply the map coordinates SW 23-43-25-W3, and directions to a place called Winter scribbled on the brown paper the cheese was wrapped in. An English innocent in a harsh unbroken landscape where there is ‘not much call for cash‘, and ‘neighbour is a relative term‘.

His closest neighbours are a brother and sister, Paul and Petra Slaymaker, whose lives become intimately entwined with his own. Beautiful relationships are established which are tested in the cauldron of gossip, violence, war and illness. But their peace is threatened much more by the reappearance of a common enemy whose actions and knowledge cast a long shadow over their lives.

Gale’s writing is superb. His characters are beautifully realised, their emotions are captured with tenderness and palpable truth, and the abiding fear of loss, disgrace and exile haunts every hour of reading. Much as I revelled in the writing, though, I had a powerful feeling of desolation at times. Harry’s apologetic personality, his sad acceptance of the degrading things that happen to him, his gentle resilience, his innate decency even in the face of extreme provocation, stand in sharp contrast to the militance and ferocity of modern day campaigners for individual and collective rights. I wanted to reach out to him with compassion, understanding and reassurance.

But it’s a novel. I must instead give you a flavour of the lyrical prose:

… hot breakfast rolls as soft and pale as infancy.

… torn rags of sentences.

… they gave the impression of having emerged, fully formed, from eggs, as brittle as the waxy shells they had discarded.

There’s the heir and the spare and the heiress-beware.

A horse is ‘like a sofa with hooves‘.

‘Vaccinated by this cruel loss of his first daughter, he approached fatherhood the second time round with a certain reserve. He did not consciously harden his heart, but he loved with hands metaphorically behind his back.’

‘… war was declared in August, when harvest preparations were at their height. The news was sown swiftly, shaken from pulpits and scattered by posters and threshing gangs.’

At this time of year it somehow seems extra tragic when bad things happen to good people. Aside from the global crises afflicting our world and unravelling before our eyes in our living rooms, I personally have a number of friends currently facing serious illness, impending death, sudden bereavement, and yet it must seem like everyone around them is caught up in trivia and pleasure, festivities and excess – in reality of course, who knows how many others are only hiding stresses and problems from public consumption?

It’s in this spirit that my mind has been wandering over the huge dilemmas facing different families; what would I choose in their circumstances? how would I cope?

Metropolitan police officer Heidi Loughlin, 33, discovered she had an aggressive form of breast cancer the day after finding out she was pregnant with her third child. She decided not to have a termination of the pregnancy but to delay treatment until after the birth. Her condition became so serious however that her baby girl was delivered by Caesarean Section on Friday, 12 weeks early, and Heidi has been given a short time to recover from the operation before starting powerful chemotherapy next week. She faces a pretty gruelling Christmas, but is determinedly looking forward to March when she will get her baby girl home to her two brothers. She has risked her life to give her daughter a chance and says she has no regrets; it was all worth it. What would I have chosen in this situation, I wonder? What would you?

Then there’s fireman Patrick Hardison. He entered a burning house in Mississippi; the roof collapsed on him leaving him with severely disfiguring burns across his face, head, neck and upper torso. Think for a moment of the pain of a small burn from an oven shelf, a hot iron … Multiply that by ten trillion. Even after 70 operations he was still so terribly mutilated (see pictures here if you can cope with them) that he would only go out heavily disguised. What kind of Christmases has he endured, I wonder? He recently underwent the most extensive face transplant ever performed. Factor in not only the excruciating pain at every stage but the risks … would I have been courageous enough to want to go on living? Would you?

Within the last two months, two transgender women have been found dead in their cells in all-male prisons: 21 year old Vikki Thompson in November, and 38 year old Joanne Latham in December. No more Christmases for them. Many difficult questions present themselves where transgender people are concerned and there is generally much greater sensitivity to their issues, but what about when they commit crimes, serious offences that land them in prison? Not only their own welfare is at stake but that of their fellow prisoners. Where would you have housed these two? Nearly 150,000 people signed a petition to house a third person, 26 year old Tara Hudson, in a female institution even though she had been convicted of assault. Would you have signed it?

A 50 year old woman, mother of three, is so determined not to grow old and ‘lose her sparkle’ that she has refused to undergo kidney dialysis. Her kidneys were seriously damaged when she took an overdose following a diagnosis of breast cancer. For years her life style has been chaotic to say the least, and one wonders, what is Christmas like in that household? Whatever, the Hospital Trust responsible for her care appealed to the courts to have treatment imposed against her wishes. But a senior judge has upheld her right to an autonomous choice to die. Was he right to do so, do you think?

I’m merely scratching the surface by way of illustration. Remember all the cases we’ve heard about recently – various scandals around abortions carried out on the grounds of gender alone; teenagers killing themselves because they’re obsessed with losing weight; all the dire warnings about how to deal with declining fertility; the consequences of a simple blood test at 18 weeks pregnancy that allows screening for thousands of genetic conditions … the list goes on and on. My files are bulging with clippings and articles.

So at this time of celebration and joy, let’s spare a thought for families caught up in tragic circumstances, and the courageous souls who try to support and guide them. May they find wisdom, courage and strength. And I wish all visitors to this blog peace as you prepare for the festive season whatever it means to you.

I’ve just spent four days in the Highlands of Scotland, walking boots on my feet, camera in hand, no intention of working in my head. A complete break after all the frenzy around publishing the latest book.

I absolutely love this stunning scenery; the majesty, the mystery, the rawness, the sheer peace of it all, so indulge me while I give you a glimpse of its beauty.But in spite of my best intentions, medical ethics (as portrayed by newspapers) did winkle its way into that bolthole. My eye and brain homed in on two issues close to my heart at the moment. Individual rights: triggered by the discussion on veiling the face in court or in school. Abortion: the question of whether there’s any meaning at all in the Abortion Laws of this country if doctors are not prosecuted when they’re caught authorising the abortion of fetuses because they happen to be the ‘wrong’ gender. But my resolve held! I merely saved the relevant articles, and refrained from scribbling a single word into my notebook.

Now I’m back in harness, refreshed and raring to go. The work of promoting Over My Dead Bodygoes on, and invitations to speak about it are coming in, but I’m ready to get thoroughly immersed in a new topic too. I’ve just downloaded 14 e-books and ordered 21 paperbacks on the issue of eating disorders which should hopefully get me started.

Out and about with the granddaughters this week, we’ve learned a lot of fascinating statistics about owls, debunking a fair few urban myths along the way. (Did you know that The Scottish Owl Centre houses one of the largest collection of owls in the world? Yep – fact not fantasy. Everything from the huge Siberian Eagle Owl to the dinkiest Scops Owl – 40 species, 100 birds.) Anyway, contrary to popular conception, owls are not wise, which makes them a fitting symbol for what I want to say in this blog.Last week the following email appeared in my Inbox: ‘On behalf of the Goodreads team, I want to say thank you. You’re in the top 1% of reviewers on Goodreads! Your many thoughtful book reviews help make us a vibrant place for book lovers.’

Wow! Goodreads is ‘the world’s largest site for readers and book recommendations!’ – by it’s own description anyway, so I indulged in a little warm glow. Top 1%, huh? Not to be sniffed at. But then I discovered that they’ve just announced that they ‘now have 20 million members, up from 10 million members just eleven months ago.‘

OK, do the maths, and I’m one of 200,000 top reviewers. Hmmm. Not that impressive, eh? Especially not since reading is part of my job. But I find their site really useful for keeping tabs on what I’ve read, when, and what I thought of each book. So thanks, Goodreads, for a very useful facility.

You might remember I was toying with two topics for my next book: anorexia or abortion. Well, I decided the next step might be to see how many other novelists have written in this area – suss out the competition. Assess where the biggest gap is.

Type ‘novels including anorexia‘ into Google and up come 52 titles through just Goodreads and Amazon. With a footnote saying ‘218 best eating disorder books’ which presumably means non-fiction. Do the same thing for abortion, and 27 come up. Hmm. Not what I was expecting. Of course, it could all be to do with shelving, the blurb available, keywords, that kind of thing. I’m sure more will surface once I start reading. And I quickly discovered that a large proportion of the eating disorder ones are teen fiction.

By reading synopses and reviews of them all, I’ve whittled it down to a dozen must-reads on abortion and probably 29 on anorexia. Looks like I’m in for the long haul, anyway. Watch out for an onslaught of reviews, Goodreads!

With Over my Dead Body about to go to the printer, my mind keeps straying to the next novel. I’m simply itching to get going again. If you’re a follower of my blog you’ll know I keep a pile of folders with ideas and plots and topics for the future, and this time I’ve whittled the choice down to two: one about abortion or one involving anorexia. No shortage of material for either.

So you’ll understand why my eye honed in on two articles in Friday’s news. First up: Women who have nine abortions. Nine? Wow.

In a former life, as a healthcare professional, I very occasionally cared for women who were having abortions. Actually, I’m old enough to have witnessed the effect of backstreet and DIY abortions in the years before the Abortion Act was passed in 1967, coming into effect in clinical practice in 1968. None of us would want to go back to that horror, I’m sure. Women died and were horribly mutilated. Health care staff were traumatised.

After the procedure became legal in the UK, I personally elected not to be active in the termination process, or to wish to know why the women had chosen this path, but I had no reason not to look after them as patients. Most were distressed and chastened by the experience, and I’ve known some who went on to develop mental health problems as a consequence. Only rarely did I encounter women who were using abortion as a form of birth control. But even with this background, the week’s statistics have still shocked me.

A Department of Health report shows that a total of 185,122 terminations of pregnancy were carried out in England and Wales last year. Of those, more than 66,000 were repeat procedures. Over 4,500 had had at least four abortions, 1,334 were up to at least their fifth termination, and 33 women had had nine or more. Just pause for a moment and think about that – the loss of life … and the effect on these thousands of women … and on society. Is this an acceptable set of statistics? Is this what the Bill was all about?

The second news item featured the other end of the scale: the Irish abortion Bill, otherwise known as The Protection of Life during Pregnancy Bill. Back in ‘my time’ I was aware that women secretly came over to Britain from Ireland to seek the help they wanted because there was an absolute ban on terminations over there. They still do apparently (about 4,000 last year according to Irish Department of Health figures) – the sheer scale of today’s abortion-tourism was a revelation to me.

Twenty years ago their Supreme Court ruled that women in Ireland were legally entitled to a termination if it was necessary to save the mother’s life, but six successive governments since have failed to introduce legislation to enforce this. Until now. This week. July 2013. 46 years after the UK allowed legal terminations.

It was the much-publicised death of 31-year-old Savita Halappanavar from septic shock last autumn after being denied an abortion, which precipitated this latest attempt to make the procedure legal in certain circumstances: where there is risk to life or the woman is suicidal. And please note, we’re not talking about frivolous reasons or social convenience here; we talking about life-or-death decisions. Nevertheless, the debate has been and remains a hotly contentious issue, involving nasty things like open aggression and death threats and letters written in blood. Even Mrs Halappanavar’s grieving husband has been sent hate mail by anti-abortion activists.

This is groundbreaking stuff in Ireland. Parliament has been in an uproar, with resignations and expulsions and threats of excommunication from the church. Lobbying groups are threatening to bring court cases to challenge this new law. Even though, as it stands, this Bill only helps a very limited number of women. Those who are pregnant as a result of rape, those with fatal fetal anomalies, those who simply can’t face the prospect of another child, are not included in this legal entitlement. What would you say to that?

So yes, the subject remains an ongoing hot potato. Lots of ethical issues to grapple with. Many indeed that might get me into big trouble too were I to write about them! Only question is, will this be my ninth novel? Or will I take on anorexia? I’m still swithering.

I confess at the moment I’m really tempted by the eating disorder and all its ramifications, only that didn’t hit the headlines this week. And I have a title for that book already!

We’ve heard so much negative comment lately about people with religious beliefs being bigoted and intolerant, I want to share an entirely different experience with you.

When last year I received an invitation to run a series of workshops on the challenges of medical ethics for a group of Christians (from the Christadelphian Church) near London in March 2012, I confess I hesitated for lots of reasons. But the organisers were very persuasive, and I eventually succumbed to their flattery.

The conference was this past weekend. And I’ve survived to tell the tale.

Life has been very pressurised of late and I had a lot of baggage to shed in order to free my mind up to facilitate group work effectively. So I used the journey south to unwind, visiting two magnificent National Trust properties. The first was Fountains Abbey in Yorkshire,with its awesome architecture and stonework, and its dramatic cloister.Just standing surveying all this ancient beauty, soaking up the centuries of peace and devotion, is balm to the troubled soul.

And then on to Ickworth in Suffolk, very grand, housing fabulous paintings, and also steeped in history.

(SORRY: photos inadvertently lost.)

Oh, and a quick trip to nearby Ixworth Thorpe to see the house where I was born. I’ve only visited once before, taking my mother round her old haunts, and it holds no memories for me because I was a mere babe when we moved from here, but it’s part of who I am. (No plaque outside yet though, I see!)

Anyway, suffice to say I’d shed a lot of tension before arriving at the High Leigh Conference Centre, in Hoddesdon, Hertfordshire. Another lovely building looking great in the sunshine.

From the moment I introduced myself the team couldn’t have been more welcoming and supportive. The whole atmosphere was warmly inclusive. So far so good.

I had five and a half hours to fill with my workshops so that took care of most of Saturday. My sessions are totally interactive and the course they run is partly determined by the cues I get from the participants, which means I have to be ready for anything. Fairly keeps the adrenaline flowing, I can tell you! But I take a few tricks up my sleeve in case things flag.

It’s my belief that, in order to understand the enormity of the choices relating to the big dilemmas of modern medicine, and to empathise with individuals and their families grappling with such questions, you need to engage emotion as well as intellect. So throughout the sessions, as I presented increasingly difficult scenarios, the delegates imagined how they might feel in such situations (eg being infertile, or dying from a degenerative disease, or suffering from psychiatric disorders, or listening to a child begging not to have any more aggressive treatment), and they moved on a continuum from very comfortable (represented by soft easy chairs with lots of cushions) to very uncomfortable (pebbles on seats and upended chairs). There was a fence to sit on for those who couldn’t decide, and we even introduced a moral high ground (high seat covered in a velvet cloth) for the few who took up a fixed moral position.

Were these Christians bigoted or intolerant? They were not. Were their minds closed to new ideas? Not a bit of it. Were they holier-than-thou? By no means. They were impressively honest and compassionate and realistic. Yes, they live to a high standard, based on a foundation of firm principles, but it was obvious there was no party line when it came to assisted dying, abortion, infertility treatment, organ transplantation … They thought for themselves. They might not agree on the solutions, but they challenged each other healthily, respectfully. They acknowledged their own prejudices, recognised the weaknesses in their arguments, and had the courage to admit there was room for change within themselves. Every single person allowed themselves to be uncomfortable, to alter their position. We laughed a lot. Some tearfully shared painful experiences. We engaged honestly with the issues. And the world is a better place because there are folk like this who have the courage and humility to accept that there are no easy trite answers, who are ready to really listen, to understand, and to support others going through life’s traumas, without thrusting their own opinions on them.

Altogether a thoroughly enjoyable and heartening experience.

Indian proverb: Judge no man till you’ve walked a mile in his moccasins.

I couldn’t have dreamed up a better precursor for my forthcoming book Saving Sebastian, due out on 1 July. But honestly, I hadn’t so much as whispered in the ear of the BBC.

The documentary, So What If My Baby Is Born Like Me?, went out at 9pm on 19 April on BBC Three, but the main players were also interviewed on various newsy programmes. The story featured Jono Lancaster, and was both poignant and challenging. Jono has Treacher Collins syndrome, which essentially involves deformities of the face and ears, but normal intelligence. And Jono’s intelligence certainly shone through, as well as his honesty, courage and thoughtfulness.

The thrust of the programme was whether or not he should father a child naturally with his girlfriend of four years, Laura. They both want children, but Treacher Collins is hereditary, and they run a 50/50 chance of having a baby with the same condition. But no one can predict how severely it would be affected. As well as the distinctive facial irregularities, some children require tracheostomies and tube feeding, some are profoundly deaf, some have cleft lips and palettes. In the course of considering their options, Jono and Laura met a little girl, Maisie, and saw firsthand what such anomalies mean to parents. And to the child.

And Jono knows only too well the reactions anybody with the condition will encounter. He’s even been vilified for daring to have a relationship with a pretty girl! And Laura is indeed very attractive, as you can see. Jono’s own biological parents were so appalled by his appearance that they rejected him from birth. He was taken in at two weeks of age by an amazing woman who’s fostered over twenty children. She admitted that Jono had occupied a very special place in her affections and she’d formally adopted him. Watching them together was a delight.

But before you condemn his natural mother, ask yourself, how would you react to being handed a baby looking so different from your expectations? Or walking down the street with a child whom everyone stares at? Take a look at these photos and imagine the scenario; ask yourself the questions, if you dare. I studied dozens of them and I confess I didn’t like the answers.

However even Jono’s adopted mum couldn’t help him with the quandary he was in now. As she wisely said, you might think you know what you’d do in these situations, but no one can say for certain what they would do in reality. You can’t know until it happens.

It’s a tribute to her love and acceptance and sound common sense that Jono’s instinctive preference was to adopt. Laura though, wants her own child. In an effort to work though the possibilities, they seek advice and counselling; they visit families who’ve faced some of the same dilemmas. One option they have is to go for IVF with PGD – essentially this involves creating an embryo using their own sperm and eggs, then testing it to see if it carries the defective gene. Jono seems initially to be labouring under the mistaken idea that the faulty gene would simply be removed. When he finds that the whole embryo would be destroyed, he’s morally outraged. For him this is ‘an insult’, ‘disrespectful’ to all people with a deformity or genetic disorder. The fact that he himself wouldn’t exist if this facility had been offered, gives his outrage special emphasis and extra weight.

Listening to this young couple grappling with the dilemma was peculiarly arresting even for battle-hardened me. Something so natural as having a child is for them a major issue with endless questions, doubts and fears attached. Jono’s ‘morally wrong’ argument is a massive stumbling block to progress, but in the end their conclusion is that, for them, it feels right to go for IVF with PGD, to have a child without the defect. ‘Morally wrong’ for Jono it might be, says Laura, but even so ‘it’s right’. ‘Definitely right’ for the child, Jono concedes.

The scenario in my novel is different, though many of the issues and questions are similar. Sebastian is four years old, and he has a rare blood disorder. But he’s stunningly beautiful to look at. His parents are considering having a baby by IVF with PGD to save Sebastian’s life. They too have reservations … But in this case, I’m not going to tell you the outcome!
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